Optometry Coding & Billing Alert

Question: At a recent conference I attended, someone mentioned a new rule about needing secure prescription pads for Medicaid and possibly other carriers in the future. I haven't heard anything about this. Can you tell me if we need to be making changes to our prescription-writing procedures?

Pennsylvania Subscriber

Answer: You heard correctly. Soon your office may have to write any prescriptions for Medicaid patients on a tamper-resistant pad. If your state reimburses for over-the-counter drugs, you-ll need to use the tamper-resistant pad for those drug orders as well.

Originally, the new law was to take effect on Oct. 1, but on Sept. 28 President Bush signed a bill delaying the implementation until April 1, 2008.

According to a letter written to state Medicaid directors, a tamper-resistant prescription pad must contain at least one of the following three characteristics:

- one or more industry-recognized features designed to prevent unauthorized copying of a completed or blank prescription form

- one or more industry-recognized features designed to prevent the erasure or modification of information written on the prescription by the prescriber

- one or more industry-recognized features designed to prevent the use of counterfeit prescription forms.

Note: This new requirement applies if Medicaid is the primary or the secondary payer for the prescription, so you-ll need to keep this in mind for your patients with Medicare primary and Medicaid secondary.

Exceptions: You don't have to worry about this new rule for refills of prescriptions delivered prior to the implementation date. Additional exceptions apply, such as electronically transmitted prescriptions, faxed prescriptions, or phoned-in prescriptions. You can read more about the new regulations at http://www.cms.hhs.gov/center/intergovernmental.asp.

-- Answers to You Be the Expert, Reader Questions and Building a Better Business reviewed by David Gibson, OD, FAAO, practicing optometrist in Lubbock, Texas.